A nurse is collecting data from a newborn who has respiratory distress syndrome and is experiencing respiratory acidosis. Which of the following risk factors predisposes the newborn to respiratory difficulties?
Small for gestational age.
Maternal history of asthma.
Ventricular septal defect.
Cesarean birth.
The Correct Answer is A
Choice A reason:
Small for gestational age (SGA) newborns are at risk for respiratory distress syndrome (RDS) and respiratory acidosis because they have immature lungs that produce less surfactant, which is needed to keep the alveoli open and prevent atelectasis. SGA newborns also have less glycogen stores, which can lead to hypoglycemia and impaired oxygen delivery to the tissues.
Choice B reason:
Maternal history of asthma is not a risk factor for RDS or respiratory acidosis in the newborn. Asthma is a chronic inflammatory disorder of the airways that affects the mother, not the fetus. Maternal asthma can cause complications such as preterm labor, preeclampsia, or intrauterine growth restriction, but it does not directly affect the fetal lung development or function.
Choice C reason:
Ventricular septal defect (VSD) is a congenital heart defect that causes a hole in the wall between the ventricles of the heart. This can result in increased pulmonary blood flow and pressure, which can lead to pulmonary edema and heart failure in the newborn. However, VSD does not cause RDS or respiratory acidosis, which are related to lung maturity and surfactant production.
Choice D reason:
Cesarean birth is not a risk factor for RDS or respiratory acidosis in the newborn. Cesarean birth can increase the risk of transient tachypnea of the newborn (TTN), which is caused by delayed absorption of fetal lung fluid. TTN usually resolves within 24 to 48 hours and does not cause a significant acid-base imbalance in the newborn.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Sleepiness is not a symptom of withdrawal in newborns. Sleepiness may be caused by other factors such as hypoglycemia, hypothermia, or infection.
Choice B reason:
Constipation is not a symptom of withdrawal in newborns. Constipation may be caused by dehydration, formula intolerance, or lack of bowel stimulation.
Choice C reason:
Irritability is a symptom of withdrawal in newborns. Irritability may manifest as excessive crying, jitteriness, tremors, or increased muscle tone. Irritability is caused by the overstimulation of the central nervous system due to the absence of the drug that the newborn was exposed to in utero.
Choice D reason:
Absent or startle reflex is not a symptom of withdrawal in newborns. Absent or startle reflex may indicate neurological damage, hypoxia, or brachial plexus injury. The startle reflex, also known as the Moro reflex, is a normal response to sudden stimuli in newborns.
Correct Answer is B
Explanation
Choice A reason:
Contractions every 3 to 4 min are not a definitive sign of labor, as they can also occur in false labor or Braxton Hicks contractions. These are irregular and do not cause cervical changes.
Choice B reason:
Cervical dilation is the most reliable indicator of true labor, as it shows that the uterus is contracting effectively and preparing for delivery. Cervical dilation is measured in centimeters from 0 to 10, with 10 being fully dilated.
Choice C reason:
Pain just above the navel is not a sign of labor, but rather a possible sign of an abdominal problem such as appendicitis or gallbladder disease. Labor pain usually starts in the lower back and radiates to the abdomen and thighs.
Choice D reason:
Amniotic fluid in the vaginal vault is not a conclusive sign of labor, as it can also result from a premature rupture of membranes (PROM) or a high leak of amniotic fluid. PROM occurs when the amniotic sac breaks before the onset of labor, which can increase the risk of infection and complications for the mother and the baby.
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